Application of R.E.N.A.L nephrometry score in planning type of surgery and predicting complications in RCC patients in Gezira Hospital

Abstract

Background: Adult renal cell carcinomas account for 80–85% of all renal tumors, making them the most common primary renal tumors. As a method for categorizing renal masses by anatomical characteristics, R.E.N.A.L score is suggested to study the effect on surgical approach in addition to perioperative outcomes and complications.

Methods: A cross-sectional prospective hospital-based study enrolled 48 RCC patients in GHRDS in the period between September 2020 and September 2021. Data regarding demographics, histological subtypes, surgical approach, intraoperative and postoperative complications were collected. Based on R.E.N.A.L score, the complexity of renal tumors is grouped into low, moderate, and high.

Results: The study sample size was 48. Twenty-five participants (52.1%) were men with a mean age of 51 years. Most cases had clear cell RCC 22 (45.8%) and papillary RCC 19 (39.6%). Thirty-nine (81.5%) patients underwent radical nephrectomy (flank incision [extraperitoneal] in 32 [82.1%] and midline incision [transperitoneal] in 7 [17.3%]), and 9 (18.5%) patients underwent partial nephrectomy. One-third of the patients 15 (31.2%) had intraoperative complications and 7 (14.6%) had postoperative complications. All intraoperative and most postoperative complications were associated with radical nephrectomy (P = 0.001). According to complexity, 21 (43.8%) patients had moderate complexity, 15 (31.2%) high complexity, and 12 (25%) low complexity.

Conclusion: Most RCC patients had moderate complexity and were subjected to radical nephrectomy. High complexities were linked to the decision of radical nephrectomy, and intraoperative and postoperative complications. More prospective research with large sample size and multi-centered studies is essential to ensure the generalizability of study findings.